CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Tufts Medical Center

Billing Code: 45380 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$1,540

about 1.3× the $1,223 Medicare rate · typically $1,150–$2,254

modeled estimate · not a bill or quote

What this hospital charges insurers

$2,250

Above the fair price

about $710 over the fair price · 1.8× Medicare

Medicare pays $1,223 Fair price $1,540 This hospital $2,250 Cash price $1,743 Hospital's list price $2,490

How we calculate the fair BaseRate →

How this hospital compares to other MA hospitals

Highest price of the 9 MA hospitals we have prices for — worth calling around.

Cheapest $395 Priciest $2,250

Black dot = this hospital, among the 9 MA hospitals with a price for this procedure. Full list below.

A fair price for a Colonoscopy with biopsy is about $1,540 (about 1.3× the $1,223 Medicare rate). Tufts Medical Center charges insurers about $2,250, or about $1,743 in cash — above the fair price. Located in Boston, MA.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $1,540. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

4 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna HumanaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$685 - $2,490	56%
Blue Cross Blue Shieldmajor	$671 - $2,490	55%
Aetnamajor	$389 - $2,490	32%
Cignamajor	$1,005 - $2,490	82%
AmeriHealth	$436 - $872	36%
AvMed	$436 - $872	36%
GEHA	$436 - $872	36%
Harvard Pilgrim	$685 - $1,370	56%
Tufts Health Plan	$354 - $2,490	29%
WellSense	$327 - $887	27%
+ 105 smaller / regional plans	$436 - $2,490

Government programs also on file: Medicare, Medicaid.

Excludes 12 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 1,743), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 45380.

Insurance Before you use insurance

Call your insurance company to confirm Tufts Medical Center is in-network.
Ask your insurer whether prior approval is required for CPT code 45380.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Tufts Medical Center

Compare: Colonoscopy with biopsy at other MA hospitals

Metrowest Medical Center · Framingham $395
St Vincent Hospital · Worcester $395
North Adams Regional Hospital Corporation · North Adams $873
Cambridge Health Alliance · Cambridge $1,120
Newton-Wellesley Hospital · Newton $1,120
North Shore Medical Center - · Salem $1,246
Massachusetts General Hospital · Boston $1,246
Brigham and Women's Hospital · Boston $1,246

Insurance negotiated median for the same procedure, sorted lowest first.